Just the other day, while walking down 42nd Street in New York City, I passed by a middle-aged man, down on his luck, sitting on the sidewalk with a handwritten cardboard sign next to him. Now this sight in itself is unfortunately not unusual in New York or any other urban center. However, this guy was clearly different, possibly even a marketing genius. His sign read “I listen to your problems… 3 dollars.”
His problem was that I didn’t have three dollars in my pocket. So I wandered down the street, imagining that in a month’s time that guy will be a millionaire and franchising out his sidewalk therapy business all across the country.
Three dollars to listen to your problems? If anything the guy was seriously under pricing his service. He obviously hasn’t dealt with our health care system recently. If I had had three dollars, I would’ve gladly paid him, sat down and told him this:
The other week I managed to somewhat fracture my fibula while running. Frankly, prior to this incident, I wasn’t aware that I possessed a fibula or two. For those of you who haven’t attended medical school, the fibula connects your ankle bone to your spankula and basically allows your sprocket to move up and down.
Anyway, I was traveling at the time and didn’t bother to see a doctor, despite my ankle swelling up and a certain level of pain occurring whenever I engaged in strenuous activities like standing or sitting.
Once home, I decided to visit my family doctor, a genial fellow who undoubtedly could give me solid fibula advice. He took a couple pictures using what he called an “X-ray machine” and declared it slightly fractured.
Here’s where it all went wrong. After settling my bill with a small pig and some tasty apricot preserves, my well-meaning family doctor suggested I take the X-ray pictures, drive to the big city and go to an orthopedic practice where they could render a second opinion.
I drove 30 minutes to a corporate office block, found the orthopedic practice and registered at the reception desk with one of the several administrative assistants sitting behind the counter. It vaguely reminded me of an office steno pool from the old days…I remember thinking “…my, this is quite the busy orthopedic practice. I wonder what all these office folk do round here?”
After waiting for 20 minutes in the lobby, I was walked into a small examination room. Four minutes later I was done and walking out of the office. Literally…the doctor, an orthopedic surgeon, entered the room, introduced himself, we chatted amiably for a minute, I explained what had happened, he sat opposite me looking at my general fibula area, stared at the X-ray, declared it okay and suggested I come back in a few weeks for another visit. Four minutes.
Shortly thereafter, the postman delivered a statement from my insurance company. My wife, as a rule, handles all our financial and administrative activities because, as a rule, she is far smarter than I am. I’m sitting in the family room drinking a martini and admiring my fibula’s recovery when she walks in and asks “…did you have orthopedic surgery?” “Why no,” I respond. My wife and I often have this sort of witty repartee. It’s like a Nick and Nora film around my house.
Turns out, after my four minute fibula consultation, during which the doctor felt the pulse in my foot but otherwise avoided any direct contact, his army of administrative assistants decided to file paperwork with my insurance company using the code for orthopedic surgery, thusly resulting in a charge of almost $1,400 U.S. dollars. What a load of crap.
Today I got a call from my insurance company. We had asked them to investigate the charge and ensure we weren’t the victims of some orthopedic hijinx. Apparently, they reviewed the charge and the code used by the doctors office and decided everything was A-OK.
I sputtered on the phone about overpricing and how bureaucracy had created a massive army of employees devoted to navigating paperwork and the insanity of charging $1,400 to glance at my fibula. I wrapped up my almost incoherent rant to unknown insurance company phone guy by blaming our national debt and general poor economic situation on a health care system that has grown inefficient, insane and soon to be insolvent. He was, if anything, completely disinterested. I decided against explaining to him my theory of how big government is basically to blame for most of our aches and pains.
I was told not to worry. The insurance company would only reimburse the doctor’s office $740 dollars, the rest could be paid out of my pocket. Somehow that was supposed to make me feel better.
So now I’m writing a check for $620 dollars to cover a couple minutes in a doctor’s office during which I was told “looks fine… take it easy for a while.”
Here’s what really hurts... I could’ve gotten that advice for $3 dollars on the streets of New York City.
Mike Baker is a former CIA covert operations officer. He is president of Diligence LLC, a global intelligence and security firm.